Provider Demographics
NPI:1780871814
Name:GRIFFITH, JAMIE ANN (LICSW, CDP)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:ANN
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:LICSW, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 S DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3357
Mailing Address - Country:US
Mailing Address - Phone:509-529-3139
Mailing Address - Fax:509-527-0942
Practice Address - Street 1:120 E BIRCH ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3054
Practice Address - Country:US
Practice Address - Phone:509-240-4179
Practice Address - Fax:509-527-0942
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00005587101YA0400X
WASW000094581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)